March 2009

With no clear definition of surgical comanagement, it's no wonder that hospitalists
disagree on which patients should be comanaged, how arrangements should be structured,
and whether the whole movement toward comanagement is a boon or bane for hospitalists
and their patients. Our cover story examines the concept and offers tips on making
comanagement work for your group.

Johns Hopkins Bayview Medical Center in Baltimore recently introduced a hospitalist-led
bed management program in a successful attempt to improve emergency department wait
times and decrease ambulance diversion hours. Find out how they did it.

Would you pass “the eyeball test” if the patient in this case study
presented in your hospital's emergency department? Find out how one physician pressed
for a better answer on a patient who presented with cardiac pain but no evidence of
a heart attack.

Most hospitalists comanage surgical patients as part of their day-to-day responsibilities,
but the hows, whens and whys of a comanagement relationship can vary from hospital
to hospital and even from physician to physician.

Nobody would want their child riding on an icy road at 70 miles per hour in a school
bus driven by someone whose head keeps nodding. Similarly, who would want to be cared
for by a physician who is so fatigued he canâ€™t remember the
difference between the cranium and the cremaster?.

In accordance with a law passed by Congress late in 2006, physicians and other eligible
professionals are able to receive bonus payments of a percentage (increased to 2%)
of their total allowed Medicare charges, subject to a cap, by submitting information
for defined quality measures.

ACP Hospitalist provides news and information for hospitalists, covering the major issues in the field. All published material, which is covered by copyright, represents the views of the contributor and does not reflect the opinion of the American College of Physicians or any other institution unless clearly stated.